CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Medical City Plano

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90837
Insurance Median: $183
Cash Discount Price: $545
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Medical City Plano is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $545. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.01x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.

Cash / Self-Pay

$545

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $545 (301%)

Insurance Median: $183 (101%)

Cash: $545 (301% of Medicare)

Ins. Median: $183 (101% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Humana	$34	19%
Superior Health Plan	$38	21%
Cigna	$74 - $203	41%
Aetna	$89 - $330	49%
United	$95	52%
Oscar	$113	62%
Healthcare Highways	$134 - $184	74%
Blue Cross Blue Shield	$135 - $242	74%
Evry Health	$141	78%
Lifecare Hospitals	$164	90%
Curative Administrators	$218	120%
Prominence Health Plan	$218	120%
City Of Mckinney	$245	135%
Fidelis Securecare	$245	135%
National Choicecare	$273	151%
Pc Texas Partners	$300	165%
Physicians Coop Of Tx	$300	165%
Rockport Health Group	$300	165%
Averde Health, Inc	$316	174%
Texas Healthcare Foundation Wc	$354	195%
Coastal Comp Health Networks	$382	211%
Mega Life	$382	211%
Multiplan Phcs	$382	211%
Healthsmart Preferred Care	$409	226%
Lewisville Isd/Dls Consulting	$409	226%
Usa Managed Care	$436	240%
Usc Health Services	$436	240%
Galaxy Health Network	$463	255%
Independent Medical Systems	$545	301%
National Healthcare Solutions	$545	301%
Unicare	$545	301%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $545.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90837.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Plano is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90837.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.